Medicare Compliance & Reimbursement
JOHNS HOPKINS CAPS OFF PATH PROBE
Johns Hopkins University emerged from a long-running physicians-at-teaching-hospitals audit relatively unscathed February 14, capping off a federal inquiry by agreeing to pay an $800,000 settlement.
That’s a relative pittance when compared to some of the other settlements that have arisen from the notorious PATH initiative, which in some cases have exceeded $10 million per institution. PATH audits are designed to verify academic medical centers’ compliance with Medicare rules governing services provided by teaching physicians and residents or interns.
As with other PATH settlements, in the Johns Hopkins case the government maintained that JHU submitted claims for certain faculty physicians without adequate documentation that they were personally involved in providing the care. The feds contended that those services were actually provided by interns or residents, who aren’t eligible to bill Medicare directly for the services they provide.
In addition to the relatively low dollar value of the settlement, JHU also got off without having to enter into a corporate integrity agreement with the HHS Office of Inspector General.
Instead, Hopkins will have to review its Medicare billing practices to ensure teaching physicians properly document their services, and make sure its policies are consistent with payment rules for teaching physicians and residents.
Medicare Compliance & Reimbursement
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